Los determinantes ambientales y las representaciones socioculturales en la transmisión de enfermedades

Abstract

This research was carried out in Bisira, an indigenous community of the Ngöbe ethnic group from Panama. This paper deals with the implementation of a health project for malaria control without the use of DDT and with special emphasis in the participation of the community. The research is divided in two parts: the first one describes the methodological framework of the project implemented by the Pan-American Health Organization and the Panamanian Health System. Also explains the development of the project, main objectives and approaches within the indigenous society. The second part of the paper is an analysis of the insertion of the project in the indigenous society through an understanding of the conceptions of malaria, the spaces of interpenetration of the disease, physical, socio cultural and individual and finally, in the field of the ngöbe health system, nosographic, etiologic and therapeutic. The paper tries to describe how these conceptions reconstructed the intervention process. The results of this research allows to understand the deconstruction sociocultural spaces of the malaria intervention and allowed to develop and "ethnic style" of prevention and control of the disease through the physical-biological acknowledgment of the ecosystem. The research sheds light on how the work with a society, different than the occidental, through the culture, acknowledging their realities, with interaction with different actors and knowledges, set basis for the emergence of a inter-cultural relationship. A dialectic interrelation is created between change and stability, interplay necessary for the project intervention.